Redesigning acute care for cognitively impaired older adults: Optimizing health care services

Michael A. LaMantia, Malaz Boustani, Shola Jhanji, Mungai Maina, Arif Nazir, Frank Messina, Amie Frame, Catherine Alder, Joshua Chodosh

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose of the study: Cognitive impairment (CI) is one of several factors known to influence hospitalization, hospital length of stay, and rehospitalization among older adults. Redesigning care delivery systems sensitive to the influence of CI may reduce acute care utilization while improving care quality. To develop a foundation of fundamental needs for health care redesign, we conducted focus groups with inpatient and outpatient providers to identify barriers, facilitators, and suggestions for improvements in care delivery for patients with CI. Design and methods: Focus group sessions were conducted with providers to identify their approach to caring for cognitively impaired hospitalized adults; obstacles and facilitators to providing this care; and suggestions for improving the care process. Using a thematic analysis, two reviewers analyzed these transcripts to develop codes and themes. Results: Seven themes emerged from the focus group transcripts. These were: (1) reflections on serving the cognitively impaired population; (2) descriptions of perceived barriers to care; (3) strategies that improve or facilitate caring for hospitalized older adults; (4) the importance of fostering a hospital friendly to the needs of older adults; (5) the need for educating staff, patients, and caregivers; (6) the central role of good communication; and (7) steps needed to provide more effective care. Implications: Providing effective acute care services to older adults with CI is an important challenge in health care reform. An understanding derived from the perspective of multiple professional disciplines is an important first step. Future research will build on this preliminary study in developing new acute care models for patients with CI.

Original languageEnglish (US)
Pages (from-to)913-930
Number of pages18
JournalDementia
Volume15
Issue number5
DOIs
StatePublished - Sep 1 2016

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health care services
Healthcare
health care
Group
hospitalization
caregiver
utilization
Cognitive Impairment
staff
reform
communication

Keywords

  • dementia
  • focus groups
  • hospital/ambulatory care

ASJC Scopus subject areas

  • History
  • Social Sciences(all)
  • Sociology and Political Science

Cite this

Redesigning acute care for cognitively impaired older adults : Optimizing health care services. / LaMantia, Michael A.; Boustani, Malaz; Jhanji, Shola; Maina, Mungai; Nazir, Arif; Messina, Frank; Frame, Amie; Alder, Catherine; Chodosh, Joshua.

In: Dementia, Vol. 15, No. 5, 01.09.2016, p. 913-930.

Research output: Contribution to journalArticle

LaMantia, MA, Boustani, M, Jhanji, S, Maina, M, Nazir, A, Messina, F, Frame, A, Alder, C & Chodosh, J 2016, 'Redesigning acute care for cognitively impaired older adults: Optimizing health care services', Dementia, vol. 15, no. 5, pp. 913-930. https://doi.org/10.1177/1471301214547089
LaMantia, Michael A. ; Boustani, Malaz ; Jhanji, Shola ; Maina, Mungai ; Nazir, Arif ; Messina, Frank ; Frame, Amie ; Alder, Catherine ; Chodosh, Joshua. / Redesigning acute care for cognitively impaired older adults : Optimizing health care services. In: Dementia. 2016 ; Vol. 15, No. 5. pp. 913-930.
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